The Crown

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and support. Care plans did not consistently reflect people’s individual needs, preferences or what was most important to them, meaning staff did not always have clear guidance on how to deliver personalised support. Although staff knew people well and were able to describe how they supported individuals’ day-to-day, this was not always reflected in written plans or reviewed regularly to ensure support remained appropriate‑. However, we saw staff recognised what mattered to people and acted with kindness and understanding.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. For example, one person’s care plan said they would benefit from Social Stories. Social Stories are short, personalised narratives that help autistic people understand social situations, routines, and expectations to reduce anxiety and improve social interaction. We spoke with the registered manager and asked to see these; however, they were unable to produce them and did not fully understand what they were. This meant people did not receive information in a way that met their individual needs, placing them at risk of misunderstanding their support and not being fully involved in their care.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. There was limited evidence of how people had been involved in their care plans or how feedback was gathered to help the provider drive change in the service.

The service did not always ensure people could access the care and support they needed at the right time. Although staff made referrals to health and social care professionals when required, gaps in records and inconsistent guidance meant people did not always receive support promptly.

Staff and leaders did not consistently recognise or respond to the needs of people who were most at risk of experiencing inequality in their care. They did not always listen to or act on information that would help tailor support, which meant people were exposed to unequal experiences and outcomes. For example, we found one person was subjected to unauthorised restrictive practices carried out by staff who were not trained to use them. People with communication needs did not always receive information in formats they could understand, meaning they were not fully involved in decisions about their care.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Goal setting for people was inconsistent, this meant people were not always supported to develop new skills or experiences. End of life plans were not in place.